Efficacy of Ketamine Gargle in Attenuating Postoperative Sore Throat

Introduction: Postoperative sore throat (POST) is a common complication of general anesthesia with endotracheal intubation that affects the patient satisfaction after surgery. The aim of the study was to compare the effectiveness of ketamine gargle with placebo in preventing POST after endotracheal intubation. Methods: Sixty eight patients scheduled for elective surgery under general anesthesia were enrolled in this study. Patients were randomly allocated into two groups, 33 in study group and 35 in control group. Study group patients were asked to gargle with ketamine (50 mg in 1 ml mixed with 29 ml of drinking water) 10 minutes before induction for 30 seconds. Controls were made to do so with 30 ml of drinking water. POST was graded at one, two, four, and 24 hrs after operation on a four-point scale (0-3). The outcome measures were compared between two groups in terms of occurrence of POST and severity of POST at one, two, four, and 24 hr to determine the efficacy of ketamine. Results: Occurrence of POST was significantly less in study group at four hours. Severity of POST was significantly low in study group at one, two and four hours as compared to that in controls. It was comparable at 24 hours. Conclusion: Ketamine gargle significantly reduced the occurrence and severity of POST.

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Ketamine gargling and postoperative sore throat

Journal of Nepal Medical Association ◽

10.31729/jnma.55 ◽

2010 ◽

Vol 50 (180) ◽

Cited By ~ 5

Author(s):

S K Shrestha ◽

B Bhattarai ◽

J Singh

Keyword(s):

Drinking Water ◽

Tracheal Intubation ◽

Endotracheal Intubation ◽

Randomized Control Trial ◽

Elective Surgery ◽

Point Scale ◽

Postoperative Sore Throat ◽

Airway Mucosa ◽

Randomized Control ◽

Induction Of Anaesthesia

INTRODUCTION: Tracheal intubation is a foremost cause of trauma to the airway mucosa, resulting in postoperative sorethroat (POST). The aim of the study was to compare the effectiveness of ketamine gargle with placebo in preventing POST after endotracheal intubation. METHODS: Forty patients scheduled for elective surgery under general anaesthesia were enrolled in this randomized, control trial. Patients were randomly allocated into two groups of 20 patients each: Group C, gargling with drinking water 30 ml; Group K, gargling with ketamine 50 mg in drinking water 30 ml for 30 s, 5 min before induction of anaesthesia. POST was graded at 4, 8, and 24 hours respectively after operation on a four- point scale (0-3). RESULTS: POST occurred more frequently in Group C, when compared with Group K at 4, 8, and 24 hours. CONCLUSIONS: Ketamine gargle reduces the incidence of POST after endotracheal intubation.

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To Compare Frequency of Sore Throat in Early Postop period in General Anesthesia and Endotracheal Intubation for Abdominal Surgeries who are given Dexamethasone and Normal Saline

10.53350/pjmhs211561227 ◽

2021 ◽

Vol 15 (6) ◽

pp. 1227-1229

Author(s):

R. Farooqi ◽

T. Iqbal ◽

M. S. Mehmood ◽

Z. Y. Bhatti ◽

F. Liaquat

Keyword(s):

General Anesthesia ◽

Sore Throat ◽

Endotracheal Intubation ◽

Normal Saline ◽

Controlled Study ◽

Control Group ◽

Chi Square ◽

Group I ◽

Chi Square Test ◽

Group Ii

Aim: To Compare frequency of sore throat in early post operative period among patients undergoing general anaesthesia and endotracheal intubation for abdominal surgeries who are given dexamethasone and normal saline. Study Design: Randomized controlled study Setting: Department of Anesthesia/ ICU, Sheikh Zayed Hospital, Lahore Duration of study: Six months i.e. 25-09-2009 to 25-03-2010. Methodology: 120 patients undergoing elective general surgery on abdomen were selected. They were divided into two groups. Group I received dexamethasone 8mg (2ml) I/V pre-operatively and group II received 2ml normal saline I/V pre-operatively. Chi square test was used. Visual analogue (VAS) scale was used for recording sore throat. The VAS score ≤4 was considered as no sore throat and VAS scores>4 were considered as the sore throat. Results: Frequency of post-operative sore throat after the first 24 hours following GA and endotracheal intubation was lower in group (I) as compared to the control group (II). Eleven (20%) patients with dexamethasone had post-operative sore throat compared to thirty one (56.3%) patients in control group. (p<0.01). Conclusion: Pre-operative use of dexamethasone was associated with decreased incidence of post-operative sore throat. Keywords: Visual analogue scale (VAS), Post-operative sore throat, general anesthesia

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Comparison of the Efficacy of 2% Viscous Lignocaine Gargle Over 5% Ketamine Gargle for Prevention of Postoperative Sore Throat in Patients Undergoing General Anesthesia with Endotracheal Intubation: A Randomized Control Trial

Indian Journal of Anaesthesia and Analgesia ◽

10.21088/ijaa.2349.8471.6619.36 ◽

2019 ◽

Vol 6 (6 (P-2)) ◽

pp. 2105-2110

Author(s):

Bhavani Vaidiyanathan ◽

◽

Sangeeta Dhanger ◽

I Joseph Raajesh ◽

◽

...

Keyword(s):

General Anesthesia ◽

Sore Throat ◽

Endotracheal Intubation ◽

Randomized Control Trial ◽

Postoperative Sore Throat ◽

Randomized Control

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Comparison of nebulized ketamine and ketamine with clonidine in postoperative sore throat

International Surgery Journal ◽

10.18203/2349-2902.isj20171515 ◽

2017 ◽

Vol 4 (5) ◽

pp. 1579 ◽

Cited By ~ 2

Author(s):

Sunita Jain ◽

Hari Prasad Bendwal ◽

Sarita Gohiya ◽

Neil Alwani ◽

Santosh Pancholi ◽

...

Keyword(s):

Sore Throat ◽

Endotracheal Intubation ◽

Postoperative Morbidity ◽

Point Scale ◽

Postoperative Sore Throat ◽

Hemodynamic Variable ◽

Double Blind ◽

Patient Dissatisfaction ◽

A Minor ◽

Control Clinical Study

Background: Postoperative sore throat (POST) consider a minor ailment in patients receiving general anesthesia with endotracheal intubation, seen in 21-65% cases but it causes significant distress and increases postoperative morbidity and patient dissatisfaction. This study was done to compare nebulized ketamine and ketamine with clonidine to treat POST.Methods: This was a prospective, randomized, double-blind control clinical study. After approval from institution ethical and scientific committee, study was conducted in between May 2015-April 2016. Written and informed consent was obtained from 100 patients of either sex aged between 20-65 years. ASA I-II, undergoing surgery in supine position lasting up to two hour. Patients were randomized into two groups Group K (n=50) nebulized with 50 mg ketamine (1cc) + 3cc NS =4cc, Group KC (n=50) nebulized with ketamine 50mg (1cc) + clonidine 150µg (1cc) + 2cc NS for 15 min, before general anaesthesia with endotracheal intubation. The POST and hemodynamic variable were monitored before nebulization, after nebulization, before induction, on arrival to PACU and at 4, 8, 12, 24 hours post operatively. POST was graded on 4 point scale (0-3).Results: Overall incidence of POST was 46% (Group K-40%, KC-6%). The Incidence and severity of POST were significantly attenuated in Group KC in comparison to Group K at 4 hours (P= 0.002), 8 hours (P=0.000), 12 hours (P= 0.000) and at 24 hours (P=0.000).Conclusions: Preoperative nebulization with clonidine and ketamine mixture compared to ketamine is more effective in dealing with postoperative sore throat with no adverse effects.

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Betamethasone Gel versus Intravenous Dexamethasone as Prophylaxis against Postoperative Sore Throat

Delta Medical College Journal ◽

10.3329/dmcj.v6i2.38215 ◽

2018 ◽

Vol 6 (2) ◽

pp. 73-77 ◽

Cited By ~ 1

Author(s):

Muhammad Sazzad Hossain ◽

Mamunur Rashid ◽

Anisur Rahman Babu ◽

Devashis Saha ◽

Debasish Banik

Keyword(s):

Endotracheal Tube ◽

General Anaesthesia ◽

Sore Throat ◽

Endotracheal Intubation ◽

Lower Incidence ◽

Control Group ◽

Postoperative Sore Throat ◽

Dexamethasone Group ◽

Significant Difference ◽

And Control

Background: Postoperative sore throat (POST) though a minor sequel after general anaesthesia with endotracheal intubation, it can be distressing to the patient.Objective: The effectiveness of lubricating endotracheal tube with 0.05% betamethasone gel or intravenous dexamethasone in reducing the postoperative sore throat was compared.Materials and method: This was a prospective study carried out among ninety ASA I and II informed consenting patients aged 20-50 years undergoing elective surgery under general anaesthesia with endotracheal intubation. The patients were randomly divided into three groups with thirty subjects in each group. Betamethasone gel (0.05%) was applied over endotracheal tube over 15 cm mark from the tip in group I, intravenous dexamethasone was given in group II and group III was taken as control. In post-anaesthesia care unit, an anesthesiologist interviewed all patients on postoperative sore throat at 1 hour, 6 hours and 24 hours after operation.Results: At 24 hours following extubation, there was statistically significant lower incidence of post-operative sore throat (POST) in betamethasone group compared to other two groups (betamethasone group 3.33%, dexamethasone group 20% and control group 26.66%, p<0.05). When the groups were compared in pairs at 24 hours, there was statistically significant difference in the incidence of POST between betamethasone group and dexamethasone group and also betamethasone group and control group with lower incidence of POST in betamethasone group, p<0.05. It was also observed that there was no significant difference of POST between dexamethasone and control group at 1 hour, 6 hours or 24 hours, p>0.05.Conclusion: It can be concluded that the use of 0.05% betamethasone gel to lubricate widely the endotracheal tube prior to intubation effectively reduces postoperative sore throat, compared to intravenous dexamethasone administration.Delta Med Col J. Jan 2018 6(2): 73-77

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PERBANDINGAN EFEKTIFITAS DEXAMETHASON DAN LIDOKAIN DALAM MENCEGAH NYERI TENGGOROKAN SETELAH INTUBASI ENDOTRAKEAL PADA ANESTESI UMUM

Jurnal Penelitian Keperawatan Medik ◽

10.36656/jpkm.v1i2.94 ◽

2019 ◽

Vol 1 (2) ◽

pp. 22-30

Author(s):

John Frans Sitepu

Keyword(s):

Clinical Trial ◽

General Anesthesia ◽

Randomized Clinical Trial ◽

Sore Throat ◽

Endotracheal Intubation ◽

Elective Surgery ◽

Double Blind ◽

Lidocaine Group ◽

Throat Pain ◽

Surgical Pain

Throat pain is a complication that is often found in patients with general anesthesia who use endotracheal intubation that is difficult to control even though surgical pain is well controlled using systemic analgesia. The purpose of this study was to see a comparison of the effectiveness of treatment in the prevention of throat pain in general anesthesia. This study used a double blind randomized clinical trial method conducted at three sites. The sample of this study was all patients who underwent elective surgery with general anesthesia endotracheal intubation. Statistically it was shown that there was no difference in effectiveness between Dexamethason 0.2 mg / kg and Lidocaine 1.5 mg / kgBB, but clinically the incidence of sore throat was higher in the Lidocaine group 1.5 mg / kgBB. Whereas at the 6th hour, Dexamethason 0.2 mg / kgBB statistically is more effective than Lidocaine 1.5 mg / kg in terms of reducing the incidence of sore throat after surgery.

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PERBANDINGAN EFEKTIFITAS DEXAMETHASON DAN LIDOKAIN DALAM MENCEGAH NYERI TENGGOROKAN SETELAH INTUBASI ENDOTRAKEAL PADA ANESTESI UMUM

Jurnal Penelitian Keperawatan Medik ◽

10.36656/jpkm.v1i2.117 ◽

2019 ◽

Vol 1 (2) ◽

pp. 22-30

Author(s):

John Frans Sitepu

Keyword(s):

Clinical Trial ◽

General Anesthesia ◽

Randomized Clinical Trial ◽

Sore Throat ◽

Endotracheal Intubation ◽

Elective Surgery ◽

Double Blind ◽

Lidocaine Group ◽

Throat Pain ◽

Surgical Pain

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Effect of intravenous oxycodone on the physiologic responses to extubation following general anesthesia

BMC Anesthesiology ◽

10.1186/s12871-021-01350-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Menglu Jiang ◽

Jiawei Ji ◽

Xin Li ◽

Zhenqing Liu

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

General Anesthesia ◽

Control Group ◽

Study Group ◽

Clinical Trial Registry ◽

Blood Oxygen Saturation ◽

Blood Concentrations ◽

Number Of Patients ◽

Blood Hormones

Abstract Background Endotracheal intubation and extubation may cause undesirable hemodynamic changes. Intravenous oxycodone has recently been introduced and used for relieving hemodynamic alterations in response to intubation, but there is insufficient information regarding its application in stabilizing hemodynamics during extubation in the patients emerging from general anesthesia. Methods One hundred patients, who had undergone assorted laparoscopic surgeries under general anesthesia, were randomly assigned to Control group (saline injection, 50 cases) and Study group (intravenous injection of 0.08 mg/kg oxycodone immediately after completion of the surgical procedure, 50 cases). Blood pressure, heart rate, blood oxygen saturation (SpO2) as well as blood concentrations of epinephrine, norepinephrine, and cortisol were recorded or measured immediately before extubation (T0), during extubation (T1), as well as one minute (T2), 5 min (T3), and 10 min after extubation (T4). In addition, coughing and restlessness, time of eye-opening, and duration from completing surgery to extubation as well as Ramsay Sedation Scale were analyzed. Results Blood pressure and heart rate as well as blood concentrations of epinephrine, norepinephrine, and cortisol were significantly higher in the Control group compared with the Study group at the time of extubation as well as 1, 5, and 10 min after extubation (P < 0.05). When the patients emerged from general anesthesia, 70 % of the Control group had cough, which was significantly higher than that of Study group (40 %, P < 0.05). Significantly higher number of patients manifested restlessness in the Control group before (40 %) and after extubation (20 %) compared with that in the Study group (20 and 2 %, respectively, P < 0.05). In addition, patients of Control group had lower Ramsay score at extubation (1.7 ± 0.7) as well as 30 min after extubation (2.4 ± 0.9) compared to that of the patients of Study group (2.2 ± 0.9, and 3.0 ± 0.8, respectively, P = 0.003 and 0.001). Conclusions Intravenous oxycodone attenuated alterations of hemodynamics and blood hormones associated with extubation during emergence from general anesthesia. Trial registration Chinese Clinical Trial Registry: ChiCTR2000040370 (registration date: 11-28-2020) “‘retrospectively registered”.

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To compare the frequency of postoperative sore throat with I-gel versus laryngeal mask airway in patients

10.53350/pjmhs2115123232 ◽

2021 ◽

Vol 15 (12) ◽

pp. 3232-3235

Author(s):

M. J. Ahmed Kamal ◽

Baber Zaheer ◽

Naveed Ahmed Durrani ◽

Khaleel Ahmad ◽

Sumara Tabassam ◽

...

Keyword(s):

Laryngeal Mask Airway ◽

General Anesthesia ◽

Sore Throat ◽

Laryngeal Mask ◽

Supraglottic Airway ◽

Postoperative Sore Throat ◽

Significant Difference ◽

Group A ◽

Group Members ◽

Group B

Background: In case of general anesthesia, airway maintenance along with least complications is the most important goal of team of anesthesiologists. In case of clinical practice, the laryngeal mask airway (LMA) devices have superiority in managing supraglottic airway. Recently i-gel airway has been introduced as supraglottic airway equipment (disposable). Aim: To make comparison between laryngeal mask and I-gel with respect to postoperative complication of sore throat in case of patients who were given general anesthesia. Study design: Randomized trial Setting: Anesthesia Department Study duration: 6 after synopsis approval in total 6months of duration Methods: Candidates were divided randomly divided into two groups. In case of members of group A, patients were given i-gel where as members of group B, disposable LMA was given. General anesthesia was administered according to the standardized protocols. A day after operation, candidates were check post operatively for 24 hours, for sore throat and information was documented on Performa. Results: The candidates mean age was 44.23±15.11years in case of i-gel group members whereas 46.10±15.56 years in case of LMA group. In case of i-gel group, there were about twenty five males members and thirty five were females members . In case of LMA group members, there were about twenty six males and thirty four female members . In present case research, sore throat postoperatively was seen in case of 17(14.2%) cases, i.e. 4 (6.7%) in i-gel group while 13(21.7%) in case of LMA group. The significant difference was witnessed between members of both groups (p<0.05). Conclusion: Thus i-gel is better than LMA for general anesthesia as it has fewer chances of side effects like postoperative sore throat. Keywords: Postoperative sore throat, I-gel, laryngeal mask airway, general anesthesia

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A COMPARISON OF EFFECT OF NEBULISED KETAMINE AND NEBULISED MAGNESIUM SULPHATE IN REDUCTION OF INCIDENCE AND SEVERITY OF POSTOPERATIVE SORE THROAT - A PROSPECTIVE RANDOMIZED DOUBLE BLINDED STUDY

10.36106/gjra/4004006 ◽

2021 ◽

pp. 38-40

Author(s):

M. Selvi Annie Geeta ◽

M. Ramesh Ram

Keyword(s):

Tracheal Intubation ◽

General Anesthesia ◽

Sore Throat ◽

Magnesium Sulphate ◽

Success Rates ◽

Postoperative Sore Throat ◽

It Effectiveness ◽

Duration Of Surgery ◽

The Mean ◽

Group B

Introduction: Postoperative sore throat (POST) is a common occurrence following general anesthesia with endotracheal intubation. The incidence of POST is estimated to be 21%-65% in various studies. Irritation and inammation of the air way are considered to be the cause of POST. Although considered a minor and self limiting complication, it may cause a signicant patient morbidity, dissatisfaction and increased the length of duration of hospital stay. Various pharmacological and non pharmacological methods have been tried to decrease POST with varying success rates. Among the interventions, the use of ketamine gargle or lozenges has highest success rates, but the problem with this is the bitter taste of the drug and the risk of aspiration, so aerosol route of drug administration gained popularity among the anesthesiologists with good acceptance from the patients. It is known that N-methyl-D-aspartate (NMDA) receptors have a role in nociception and inammation. Hence, this study is aimed at using the aerosol route of magnesium sulphate and ketamine and to nd it effectiveness in preventing POST. Aim Of The Study: To evaluate the effect of nebulized ketamine and nebulized magnesium sulphate for attenuation of postoperative sore throat in patients undergoing surgeries under general anesthesia with tracheal intubation. Materials And Methods: This study was done in the Department of Anesthesiology in collaboration with the Department of Surgery in Kanyakumari Government Medical College from January 2019 to December 2019. Patient planned for surgery under general anesthesia except head, neck & ENT surgeries were selected and randomized into two groups (35 each). Each group received nebulisation for 15 min before induction of general anaesthesia. Group M: Nebulization with 500mg magnesium sulphate in 5ml NS. Group K: Nebulization with 50mg ketamine in 5ml NS. The Parameters related to the study such as duration of laryngoscopy, time taken to intubate, duration of surgery, number of attempts to intubate were recorded. Incidence and severity of sore throat were assessed by four point scale. Incidence of sore throat is assessed for 24 hours. Complication were recorded. Results: We found that the demographic parameters were comparable and statistically insignicant. The mean duration of laryngoscopy difference between the two groups Group M - 24.54± 1.12 seconds and Group K - 24.49 ±1.15 seconds was not statistically signicant P= 0.834 (P>0.05). The mean time taken to intubate in Group M - 27.54± 1.12 seconds and Group K - 27.54± 1.12 seconds was not statistically signicant with P=1.000 respectively (P>0.05). The mean duration of surgery in Group M - 90.71±15.67 minutes and the Group K - 88.20 ±16.53 minutes between the two groups was not statistically signicant P= 0.516 (P>0.05). The mean difference of number of attempts taken to intubate between the two groups was statistically insignicant P=0.771 (P>0.05). The overall incidence of sore throat in Group M was 91% and in Group B was 34%. The severity of sore throat between Group M and Group K is statistically signicant at 2, 4, 6 hrs at grade 1 and grade 2. Conclusion: On the basis of our result, we can suggest that the use of perioperative ketamine nebulization when compared magnesium sulphate nebulization reduces the incidence and severity of post-operative sore throat at 4th and 6th hour during postoperative period in patients who had received general anesthesia with tracheal intubation.

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